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Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study

Since the standard reconstructive option after large segmental resection of proximal humeral tumors remained controversial, we designed and applied plate-prosthesis composite (PPC) for this circumstance. The purposes of the study were to: compare the functional outcome, implant survival (IS), surgic...

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Autores principales: Wei, Ran, Guo, Wei, Yang, Rongli, Tang, Xiaodong, Yang, Yi, Ji, Tao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708887/
https://www.ncbi.nlm.nih.gov/pubmed/31145303
http://dx.doi.org/10.1097/MD.0000000000015787
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author Wei, Ran
Guo, Wei
Yang, Rongli
Tang, Xiaodong
Yang, Yi
Ji, Tao
author_facet Wei, Ran
Guo, Wei
Yang, Rongli
Tang, Xiaodong
Yang, Yi
Ji, Tao
author_sort Wei, Ran
collection PubMed
description Since the standard reconstructive option after large segmental resection of proximal humeral tumors remained controversial, we designed and applied plate-prosthesis composite (PPC) for this circumstance. The purposes of the study were to: compare the functional outcome, implant survival (IS), surgical risk of PPC with those of conventional proximal humeral prosthesis (PHP); and describe the design and reconstructive procedure of PPC. Twenty patients (11 males, 9 females), who received intraarticular proximal humeral resection without preservation of abductor mechanism, were included in this study, with a mean resection length accounting for 72.5% (range, 61.9–81.8%) of whole humeral length. According to the reconstructive options, we categorized patients into PPC group (9 patients) and PHP group (11 patients). PPC was a semi-custom-made endoprosthesis, with modular proximal part same as PHP and custom-made distal part including dumpy stem and composite lateral anatomic plate for distal humerus. The mechanical prosthetic complication was defined as the imaging evidence regardless of reoperation. The IS was defined as the time from surgery to the occurrence of mechanical prosthetic complication. The mean follow-up time was 40.1 months (range, 14–129). The Musculoskeletal Tumor Society 93 scores of PPC and PHP group showed no significant difference (73.3% vs 70.0%, P = .46). Compared to PHP group, PPC group showed significantly lower mechanical prosthetic complication rates (0 vs 45.4%, P = .03) and better IS (86.0 vs 59.3 ± 21.7 months, P = .028). Moreover, the comparison of surgical time (3.2 vs 3.3 hours, P = .60), blood loss (288.9 vs 376.4 mL, P = .15) and perioperative complication rates (11.1% vs 18.2%, P = .58) between 2 groups showed no differences. For reconstruction after large segmental resection of proximal humeral tumors, PPC achieved better IS while maintained similar functional outcome compared to conventional PHP without influencing the complexity and safety of surgery.
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spelling pubmed-67088872019-10-01 Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study Wei, Ran Guo, Wei Yang, Rongli Tang, Xiaodong Yang, Yi Ji, Tao Medicine (Baltimore) Research Article Since the standard reconstructive option after large segmental resection of proximal humeral tumors remained controversial, we designed and applied plate-prosthesis composite (PPC) for this circumstance. The purposes of the study were to: compare the functional outcome, implant survival (IS), surgical risk of PPC with those of conventional proximal humeral prosthesis (PHP); and describe the design and reconstructive procedure of PPC. Twenty patients (11 males, 9 females), who received intraarticular proximal humeral resection without preservation of abductor mechanism, were included in this study, with a mean resection length accounting for 72.5% (range, 61.9–81.8%) of whole humeral length. According to the reconstructive options, we categorized patients into PPC group (9 patients) and PHP group (11 patients). PPC was a semi-custom-made endoprosthesis, with modular proximal part same as PHP and custom-made distal part including dumpy stem and composite lateral anatomic plate for distal humerus. The mechanical prosthetic complication was defined as the imaging evidence regardless of reoperation. The IS was defined as the time from surgery to the occurrence of mechanical prosthetic complication. The mean follow-up time was 40.1 months (range, 14–129). The Musculoskeletal Tumor Society 93 scores of PPC and PHP group showed no significant difference (73.3% vs 70.0%, P = .46). Compared to PHP group, PPC group showed significantly lower mechanical prosthetic complication rates (0 vs 45.4%, P = .03) and better IS (86.0 vs 59.3 ± 21.7 months, P = .028). Moreover, the comparison of surgical time (3.2 vs 3.3 hours, P = .60), blood loss (288.9 vs 376.4 mL, P = .15) and perioperative complication rates (11.1% vs 18.2%, P = .58) between 2 groups showed no differences. For reconstruction after large segmental resection of proximal humeral tumors, PPC achieved better IS while maintained similar functional outcome compared to conventional PHP without influencing the complexity and safety of surgery. Wolters Kluwer Health 2019-05-31 /pmc/articles/PMC6708887/ /pubmed/31145303 http://dx.doi.org/10.1097/MD.0000000000015787 Text en Copyright © 2019 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nc/4.0 This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial License 4.0 (CCBY-NC), where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc/4.0
spellingShingle Research Article
Wei, Ran
Guo, Wei
Yang, Rongli
Tang, Xiaodong
Yang, Yi
Ji, Tao
Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title_full Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title_fullStr Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title_full_unstemmed Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title_short Plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: A retrospective comparative study
title_sort plate-prosthesis composite reconstruction after large segmental resection of proximal humeral tumors: a retrospective comparative study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6708887/
https://www.ncbi.nlm.nih.gov/pubmed/31145303
http://dx.doi.org/10.1097/MD.0000000000015787
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